索拉非尼治疗肝细胞性肝癌肝移植后的复发

摘要

背景:肝细胞肝癌肝移植后肿瘤复发转移十分常见,肿瘤进展迅速,缺乏有效治疗方法.目的:观察索拉非尼联合介入治疗肝细胞性肝癌肝脏移植后复发的疗效.方法:选择24例肝细胞性肝癌肝移植后肿瘤复发患者,其中单纯接受介入治疗者16例,接受索拉非尼联合介入治疗者8例,通过Log-rank检验比较两组患者移植后6个月生存率、1年生存率、移植后无瘤生存时间.结果与结论:介入治疗组移植后平均无瘤生存时间为95 d,联合治疗组为100 d,两组间差异无显著性意义(P=0.280 5).移植后终生随访,介入化疗组16例全部死亡,中位生存时间为211 d,6个月生存率为69%,1年生存率为25%.联合治疗组死亡2例,6个月生存率为100%,1年生存率为100%,两组间差异有显著性意义(P < 0.000 1).说明对于肝细胞性肝癌肝移植后肿瘤复发患者,采用索拉非尼+介入治疗联合治疗方案可显著提高患者生存期及生存率.%BACKGROUND: Recurrent hepatocelluar carcinoma is very common after liver transplantation. There are no effective therapies for recurrent hepatocelluar carcinoma due to the rapid progress of tumor.rnOBJECTIVE: To observe the effects of sorafenib plus transcatheter arterial chemoembolization (TACE) and adjuvant chemotherapy in patients with recurrent hepatocelluar carcinoma after liver transplantation.rnMETHODS: The clinical data of 24 patients with recurrent hepatocelluar carcinoma after liver transplantation were analyzed. Sixteen patients were only treated with TACE and adjuvant chemotherapy (control group); eight patients were treated with sorafenib plus TACE and adjuvant chemotherapy (combined group). The survival rates of 6 months and 1 year as well as tumor-free survival time were compared between two groups by Log-rank test.rnRESULTS AND CONCLUSION: The patients in the control group all died within 95 days of tumor-free survival time, whereas 100 days in the combined group, and there was no significant difference between two groups (P=0.280 5). During the follow-up, 16 patients in the control group were dead within 211 days of median survival time; the 6-month and 1 -year overall survival rates of control group were 69% and 25%, respectively. Two patients were dead in the combined group within 1 100 days of the median survival time, the 6-month and 1-year overall survival rates were both 100%. There was significant difference in 6-month and 1 -year overall survival rates between two groups (P < 0.000 1). Sorafenib plus TACE and adjuvant chemotherapy may prolong the survival of patients with recurrent hepatocelluar carcinoma after liver transplantation.